Understanding the nature of health: New perspectives for medicine and public health. Improved wellbeing at lower costs

Abstract

Background: Current dilemmas of health care systems call for a new look at the nature of health. This is offered by the Meikirch model. We explore its hypothetical benefit for the future of medicine and public health. Meikirch model: It states: “Health is a dynamic state of wellbeing emergent from conducive interactions between individuals’ potentials, life’s demands, and social and environmental determinants.” “Throughout the life course health results when an individuals’ biologically given potential (BGP) and his or her personally acquired potential (PAP), interacting with social and environmental determinants, satisfactorily respond to the demands of life.” Methods: We explored the Meikirch model’s possible applications for personal and public health care. Results: The PAP of each individual is the most modifiable component of the model. It responds to constructive social interactions and to personal growth. If an individual’s PAP is nurtured to develop further, it likely will contribute much more to health than without fostering. It may also compensate for losses of the BGP. An ensuing new culture of health may markedly improve health in the society. The rising costs of health care presumably are due in part to the tragedy of the commons and to moral hazard. Health as a complex adaptive system offers new possibilities for patient care, particularly for general practitioners. Discussion: Analysis of health systems by the Meikirch model reveals that in many areas more can be done to improve people’s health and to reduce health care costs than is done today. The Meikirch model appears promising for individual and public health in low and high income countries. Emphasizing health instead of disease the Meikirch model reinforces article 12 of the International Covenant on Economic, Social and Cultural Rights of the United Nations – that abandons the WHO definition - and thereby may contribute to its reinterpretation.

Will the Meikirch Model, a New Framework for Health, Induce a Paradigm Shift in Healthcare?

“…Health results throughout the life course when an individual’s potentials – and social and environmental determinants – suffice to respond satisfactorily to the demands of life. Life’s demands can be physiological, psychosocial, or environmental and vary across individuals and contexts but, in every case, unsatisfactory responses lead to disease” [5-6]. …”

“…In this situation, the physician must consider all five components and all ten interactions of the system [6]. As a result, some critical aspects may be discovered that can be discussed with the patient.…”

“…The model uses a framework of health consisting of five components that are related to each other by 10 complex interactions. This concept has received attention because it allows health and disease to be observed and analyzed in a new context and with new consequences [6]. The model has also been explored for its applicability in the practice of healthcare [7].…”

“Multimorbidity” as the manifestation of network disturbances. From nosology to the Meikirch model

“…Representation of health by the Meikirch model . There are 5 components and 10 complex interactions expressed as double arrows.…”

“…The question remains, however, whether or not it is needed and possible to develop the whole diagnostic picture from molecular genetics to the person and its surroundings in each case. This commentary has the purpose to explore the possibility to analyze patients in a more focused manner by raising the following question: Is it possible to do the best for the patients, when applying a recently described model of health and disease, the Meikirch model? Can it identify the factors that are predominant in rendering a patient diseased, and can it help the patient to evolve further and to emerge into a better state of health? This method also gives a single picture instead of a nosological analysis of many diagnoses.…”